Chronic hepatitis C virus (HCV) infection affects 40,000 HIV positive patients in the United States. HCV treatment is associated with life-threatening side effects and antiretroviral drug interactions. Without treatment, increasing numbers of HIV positive patients will either die from end stage liver disease or from HIV-related complications because of the inability to use antiretroviral agents due to their hepatotoxicity. Data are limited, but the clinical impression is that this population less often accepts or completes HCV treatment. More information is needed about the experience of HIV-infected patients as they manage the process of HCV treatment. The purpose of this qualitative, longitudinal study is to develop a clear understanding of HIV-infected patients' experiences with HCV treatment. This understanding will improve our ability to design clinical interventions that support HCV treatment efforts in co-infected patients. The specific aims of this study are to (1) describe the subjective experiences of HIV-infected patients as they manage the process of HCV treatment, (2) examine the influence of health related quality of life, symptom experience, mental illness, substance abuse and the role of health care providers on the experience of HCV treatment in co-infected patients, and (3) explore the association between demographic, clinical cofactors and the HCV treatment experience. In-depth qualitative interviews will be conducted with 40 HCV/HIV co-infected patients at three time points (before treatment, 8-12 weeks into treatment and at treatment completion). Subjects who choose not to be treated will be interviewed also. The constant comparative method of content analysis will be used to abstract interview data on the HCV treatment experience. A meta-matrix will be used to integrate the qualitative, demographic and clinical cofactor data (HCV treatment adherence, HIV RNA, HCV RNA, HCV genotype, liver pathology, complete blood counts, liver function tests, HIV illness stage and co-treatment with antiretroviral agents). The proposed study is an essential step towards developing the foundation for clinical trials that test HCV treatment interventions among HIV-infected patients. Results of this study will also be valuable to clinicians, educators, researchers and those who develop treatment guidelines for HCV/HIV co-infected patients. [unreadable] [unreadable]